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Related Experiment Videos

Antidepressants for smoking cessation.

J R Hughes1, L F Stead, T Lancaster

  • 1University of Vermont, Department of Psychiatry, 38 Fletcher Place, Burlington, Vermont 05401-1419, USA. john.hughes@uvm.edu

The Cochrane Database of Systematic Reviews
|January 27, 2007
PubMed
Summary
This summary is machine-generated.

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Antidepressants bupropion and nortriptyline effectively aid long-term smoking cessation, doubling cessation odds. Selective serotonin reuptake inhibitors do not show significant long-term benefits for quitting smoking.

Area of Science:

  • Pharmacology
  • Addiction Medicine
  • Clinical Trials

Background:

  • Antidepressants may aid smoking cessation by alleviating nicotine withdrawal symptoms or by directly affecting neural pathways of nicotine addiction.
  • Theoretical mechanisms include relieving depressive symptoms, substituting nicotine's antidepressant effects, or blocking nicotine receptors.

Purpose of the Study:

  • To evaluate the efficacy of various antidepressant medications in achieving long-term smoking cessation.
  • Included medications: bupropion, doxepin, fluoxetine, imipramine, moclobemide, nortriptyline, paroxetine, sertraline, tryptophan, and venlafaxine.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs) comparing antidepressant pharmacotherapy to placebo or alternative treatments.
  • Searched Cochrane Tobacco Addiction Group trials register up to September 2006.

Related Experiment Videos

  • Main outcome: smoking abstinence at ≥6 months follow-up, using odds ratios (OR) and fixed-effect models.

    • Main Results:

    • Bupropion (OR 1.94) and nortriptyline (OR 2.34) significantly increased odds of long-term smoking cessation when used as sole pharmacotherapy.
    • No additional long-term benefit observed when bupropion or nortriptyline were added to nicotine replacement therapy (NRT).
    • Selective serotonin reuptake inhibitors (SSRIs) like fluoxetine, sertraline, and paroxetine showed no significant long-term cessation benefit.

    Conclusions:

    • Bupropion and nortriptyline are effective antidepressants for long-term smoking cessation, comparable in efficacy to NRT.
    • Their mechanism of action appears independent of their antidepressant properties.
    • SSRIs are not effective for long-term smoking cessation based on available evidence.